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The report of the Statistical Committee of the Metropolitan Asylums Board for 1898 shows
that the ages of the five cases of small-pox treated in. the institutions of the Board during the year
ranged from 15 to 35 years, and that all been vaccinated, and all recovered.
In previous reports I have referred to the increasing proportion of children horn in London
who appear in the vaccination returns as "not finally accounted for," a proportion which has
especially increased since the appointment of the Royal Commission on Vaccination. The proportion
in successive years has been as follows. It is matter for regret that the figures for the years
1897 and 1898 are not yet available.

The Vaccination Act, 1898.
The Vaccination Act of 1898 materially alters the law as to vaccination. The principal
alterations are: (1.) The period within which a parent, or guardian, is required to cause a child
to be vaccinated is extended from three months from the birth of the child to six months
from the birth of the child. (2.) The public vaccinator shall, if the parent, or guardian, of the
child require, visit the home of the child for the purpose of vaccinating it. (3.) If a child is not
vaccinated within four months after its birth the public vaccinator is required to visit the home of
the child and offer to vaccinate it with glycerinated calf lymph, or such other lymph as may be
issued by the Local Government Board. (4.) no parent or other person is to be liable to penalty
for not causing the vaccination of a child, if, within four months from the birth of the child, he
satisfies two justices, or a stipendiary, or metropolitan police magistrate, in petty sessions, that he
conscientiously believes that vaccination would be prejudicial to the health of the child, and
within seven days thereafter delivers to the vaccination officer for the district a certificate by such
justices or magistrates of such conscientious objection.
It is too early to judge whether this Act will attain its object of better securing the
vaccination of the population with less friction than has attended the enforcement of the
vaccination law in recent years. The appointment of a Royal Commission in 1889 inevitably
led to an increase of vaccination default, and a decision of Parliament maintaining
vaccination, subsequent to the presentation of the report of the Royal Commission, would probably
lead to increase of vaccination beyond that of the period when the Commission was engaged upon
its enquiries. The question which needs to be determined, and can only be determined by the
experience of subsequent years is whether the amount of vaccination default will be found in the
future to be greater or less than before the Royal Commission of 1889 was appointed. Whether,
in fact, the new law, with the opportunity it gives for domiciliary vaccination, for the use of
glycerinated lymph, and for exemption from compulsion of the conscientious objector, will attain
the object in view. In any case, it may be pointed out that the present position of the vaccination
law gives opportunity for further legislation, such as will provide a system of revaccination of the
population. The experience of England and other countries of Europe shows such a system to be
necessary for the protection of the community against small-pox.